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BRAIN ATTACK – Myths and Truths

Myth: Brain attack is a rare disease.
Truth: Brain attack is the third most common cause of death and the leading cause of acquired disability in India. One in six people worldwide has a stroke in his lifetime with one person developing it every 45 seconds. Twenty lakh people suffer a brain attack in India every year making it more common than cancer.

Myth: Brain attack (lakva) is the result of a curse
Truth: The truth is that it is a disease of the brain just as a heart attack is a disease of the heart. The brain attack is caused by controllable risk factors like high BP, high cholesterol, alcohol consumption, cigarette smoking and obesity. It is a preventable and treatable.

Myth: Brain attack affects only old people
Truth: It can strike people of any age, from infants to the very elderly. In fact, there are cases of pre-natal or before birth occurrence of stroke. Particularly in developing countries like India, brain attack is more common among younger patients. 20-30% of all strokes occur among people under 45.

Myth: Brain attack is difficult to identify
Truth: On the contrary it is quite easy to detect. They are accompanied by tell-tale symptoms, which set in suddenly. They include: Face asymmetry, speech disturbance and arm weakness. Among other symptoms are vision problem, walking difficulty and dizziness.

Myth: Brain attack is not treatable
Truth: Recent advances in science have made ischemic brain attacks (the ones caused by blockage of a brain blood vessel) treatable. Clot bursting medication is very effective if administered within four-and-a-half hours. Advanced neurointerventional catheter techniques performed in the cath lab can remove a clot if performed within six hours of a brain attack. Physiotherapy and occupational and speech therapy can make a significant difference to the final outcome.

Myth: Brain attack happens only once in a lifetime
Truth: Brain attacks can recur if risk factors are not identified and treated. In fact, one in four or five strokes is considered recurrent by some experts. Hence, even if patients have not been attended to within the six-hour golden, with proper evaluation and appropriate medication risk of future attacks can be mitigated.

Myth: Brain attack is rare in women
Truth: Just the opposite is true. One in five women is at the risk of a brain attack worldwide. Brain attacks kill more women than breast cancer

Myth: Brain attack is not preventable.
Truth: 80-90 % brain attacks are preventable! Primary prevention involves identification and treatment of risk factors by experts. This will prevent the ‘first’ stroke from happening. Recurrent brain attacks too are preventable with proper expert evaluation and appropriate treatment.

Myth: Brain attack is a type of heart attack, treated by cardiologist
Truth: A heart attack is caused by a blocked blood vessel in the heart, which results in chest pain. It is treated by a cardiologist who may try and burst the clot with drugs or angioplasty/stenting. A brain attack is the result of a blocked brain blood vessel/bleed within the brain, which results in symptoms described above. Brain attacks are treated by stroke specialists or a team of neurologists/neurointerventionists/radiologists. Brain attacks pose a trickier challenge to doctors as they are associated with bleeding risks. Since brain attacks are painless patients tend to take it easy resulting in complications.

Myth: Brain attack has no warning signs.
Truth: Some patients suffer from mini-strokes accompanied by the symptoms mentioned above. These are transient symptoms, lasting from a few seconds to sometimes a few hours. Patients tend to improve partially or completely within a day. These are warning signs of large impending strokes.

Myth: Brain attack does not run in families
Truth: Sometimes, brain attacks and heart attacks may be hereditary. Children of people who suffered from a stroke in their younger years are more likely to inherit the problem. It is strongly recommended that people in such a high risk category undergo periodic screening by stroke experts.

Myth: It’s good to give water or prasadam to stroke victims while being transferred to hospitals
Truth: Large brain attacks can paralyse the swallowing mechanism, which can lead to saliva or anything fed to patient seeping into lungs. This is dangerous as it causes lung infection, which may spread into blood and from there to the whole body.

Myth: Only heart attacks are treatable in cath lab
Truth: Brain attacks too can be very effectively treated in cath labs by stroke specialists or neurointerventionists. As in the case of a heart attack, the treatment of brain attack too involves catheters, wires, balloons, and stents.

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